<!--
  ========================LICENSE_START=================================
  screenit-web
  %%
  Copyright (C) 2012 - 2020 Facilitaire Samenwerking Bevolkingsonderzoek
  %%
  This program is free software: you can redistribute it and/or modify
  it under the terms of the GNU Affero General Public License as published by
  the Free Software Foundation, either version 3 of the License, or
  (at your option) any later version.
  
  This program is distributed in the hope that it will be useful,
  but WITHOUT ANY WARRANTY; without even the implied warranty of
  MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  GNU General Public License for more details.
  
  You should have received a copy of the GNU Affero General Public License
  along with this program.  If not, see <http://www.gnu.org/licenses/>.
  =========================LICENSE_END==================================
  -->
<wicket:extend>
    <h1 class="pageTitle">Organisatie zoeken</h1>
    <div class="form-horizontal">
        <fieldset>
            <form wicket:id="zoekForm">
                <div class="row-fluid">
                    <div class="span6">
                        <div class="control-group">
                            <label class="control-label" for="organisatieType">Soort organisatie</label>
                            <div class="controls">
                                <select id="organisatieType" wicket:id="organisatieType">
                                    <option></option>
                                    <option>Intakelocatie</option>
                                    <option>Inpakcentrum</option>
                                    <option>Lab</option>
                                    <option>Screeningsorganisatie</option>
                                    <option>Zorgverzekeraar</option>
                                </select>
                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="organisatieNaam">Naam organisatie</label>
                            <div class="controls">
                                <input class="input-large" id="organisatieNaam" type="text" wicket:id="organisatieNaam"/>
                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="organisatiePlaats">Plaats</label>
                            <div class="controls">
                                <input class="input-large" type="text" id="organisatiePlaats" wicket:id="organisatiePlaats"/>
                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="organisatiePostcode">Postcode</label>
                            <div class="controls">
                                <input class="input-mini" type="text" placeholder="1234 AB" id="organisatiePostcode" wicket:id="organisatiePostcode"/>
                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="input01">Datum lopende overeenkomst</label>
                            <div class="controls">
                                <div class="btn-group periode-filter">
                                    <div class="input-append">
                                        <input wicket:id="lopendeDatum" type="text" placeholder="dd-mm-jaar" size="16" class="input-small datum">
                                        <a href="javascript:void(0);" class="btn" onclick="$(this).prev().datepicker('show');return false;" title="Datum" tabindex="-1"><i
                                                class="icon-calendar"></i></a>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="span6">
                        <div class="control-group">
                            <label class="control-label" for="regio">Regio</label>
                            <div class="controls">
                                <select id="regio" wicket:id="regio">
                                    <option></option>
                                    <option>Bevolkingsonderzoek Midden-West</option>
                                    <option>Bevolkingsonderzoek Zuid-West</option>
                                </select>
                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label">Overeenkomst</label>
                            <div class="controls">
                                <select wicket:id="overeenkomst">
                                    <option></option>
                                    <option>iFOBT</option>
                                    <option>Colografie</option>
                                </select>
                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="organisatieUra">Unieke code organisatie</label>
                            <div class="controls">
                                <input class="input-large" id="organisatieUra" type="text" wicket:id="organisatieUra"/>
                            </div>
                        </div>
                    </div>
                </div>
                <div class="row-fluid">
                    <div class="span12">
                        <div class="form-actions clearfix">
                            <button class="btn btn-primary" onclick="javascript:void();" wicket:id="zoeken"><i class="icon-search icon-white"></i> Zoeken</button>
                        </div>
                    </div>
                </div>
            </form>
        </fieldset>
        <div class="row-fluid" wicket:id="resultContainer">
            <div wicket:id="instellingenDataTable"></div>
        </div>
    </div>
</wicket:extend>
